NPIMap

Organization Active NPI

Florida Gastroenterology Clinic LLC

  • Gastroenterology Physician
  • Jacksonville, FL
National Provider Identifier
1861703811
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME105540 Issued in FL
Legal business name
FLORIDA GASTROENTEROLOGY CLINIC LLC
Practice address
3599 University Blvd S
Samuel Wells Complex Suite 8
Jacksonville, FL 32216
Phone
(917) 664-9972
NPI assigned
Jun 24, 2010
Last updated
Jul 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. George Hage-Nassar, MD
Title
MD
Phone
(904) 619-5225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME105540 FL Primary

Addresses

Primary practice location

3599 University Blvd S
Samuel Wells Complex Suite 8
Jacksonville, FL 32216

Mailing address

7917 Abington Hills LN
Jacksonville, FL 32256-3428
Phone (904) 619-5225

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1861703811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7917 ABINGTON HILLS LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563428",
            "telephone_number": "904-619-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "SAMUEL WELLS COMPLEX SUITE 8",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "917-664-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA GASTROENTEROLOGY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "HAGE-NASSAR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "904-619-5225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME105540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.